Monday, August 15, 2016

Assisted suicide deaths increase by 31.7% in Washington State (2015). What about the complications?

Washington State’s Death With Dignity Act, based on Oregon’s, came into operation on 9 March 2009.

Lethal prescriptions up 22% in one year - more than doubled since 2010

In the first full calendar year of operation, 2010, some 87 prescriptions for lethal drugs were provided under the Act. By 2015 this had increased by nearly two and a half times (244.8%) to 213.[1] Prescriptions for lethal drugs increased by 22% from 2014 to 2015.[2]

Deaths from assisted suicide up 31.7% in one year - more than tripled since 2010

Deaths from lethal drugs prescribed under the Act have increased three and a quarter fold (325%) from 51 in 2010 to 166 in 2015, increasing by nearly one third (31.7%) from 2014 to 2015 alone.

Not all of those who are prescribed lethal drugs end up taking them. Some die of natural causes.

285 doses of lethal drugs unaccounted for in the community

There is no tracking of lethal drugs that are not used by those for whom they are prescribed so these lethal drugs are available in the community and could be used accidentally or intentionally to cause death. Of the 936 prescriptions for lethal drugs issued since 2009 only 651 (71%) have been reported as used leaving up some 285 doses of lethal drugs unaccounted for in the community.

Main concerns are loss of autonomy and burden on family rather than pain control

Some 65% of those for whom a prescription for lethal drugs was provided did not cite any concern about pain control as a reason for asking for the prescription.

However, 86% cited concerns about loss of autonomy and 52% cited concerns about being a burden on family, friends or caregivers.

Assisted suicide to save money

Significantly, 13% of those for whom a doctor wrote a prescription for lethal drugs cited concerns about the financial implications of treatment.[3]

Very few referrals for expert psychiatric evaluation

Only 4% of those given a lethal prescription were referred to a psychiatrist or psychological for evaluation.

Doctors who barely know the patient but are prepared to assist suicide

In some cases the prescribing doctor knew the patient for less than a week before writing the prescription, and in just over half the cases (51%) the doctor knew the patient for less than 25 weeks.[4]

A peaceful death - what about the complications?

In 2013 one person took 3 hours to lose consciousness after ingesting the lethal dose and one person took 41 hours (1 day and 17 hours) to die after ingesting the dose. In 2015 one person took 72 minutes (1 hour and 12 minutes) hours to lose consciousness after ingesting the lethal dose and one person took 30 hours (1 day and 6 hours) to die after ingesting the dose. In 2009 two people awakened after initially losing consciousness. At least 9 patients have regurgitated the lethal medication. In 2014 one person suffered seizures after ingesting the lethal medication.[5]

Doctors getting the prognosis wrong and assisting suicide for people with years to live

Although the Act specifies that only persons with “six months or less to live” may request lethal doses of medication from a physician, the data shows that in each year between 5% and 17% of those who die after requesting a lethal dose do so more than 25 weeks later with one person in 2012 dying nearly 3 years (150 weeks) later, and one person in 2015 dying nearly two years later (95 weeeks).[6]

In 226 cases we do not who gave the person the lethal drugs or even if they struggled

There is no requirement under the Act for a physician or any other person to be present when the lethal dose is ingested. Since 2009 there have been 175 cases where no health-care provider was present when the lethal dose was ingested and a further 51 cases where it is not known if a health-care provider was present.[7] In other words in some 226 cases people have died ingesting a dose of lethal medication, legally prescribed under Washington law, and nobody knows whether the person freely ingested the lethal dose or they were cajoled, coerced or forced to do so by another person.

Assisted suicide may increase the overall suicide rate

Proponents have claimed that legalising physician assisted suicide would actually prevent, or at least delay, suicides by giving those faced with a terminal illness an assurance that the means for obtaining peaceful death was legally available. However, a study of comparative rates of suicide in US states found that for the states, like Oregon and Washington, which had legalised physician assisted suicide there is an increase in the overall suicide rate of 6.3% compared to all other states and of the suicide rate of those aged 65 and over of 14.5%. There is no reduction in either the rate of non-assisted suicides or in the mean age of suicide.[8]

As the above analysis shows assisted suicide is far from well in Washington State.

[1] Washington State Department of Health 2015 Death with Dignity Act Report, p. 4, (link to the report).[2] Ibid.[3] Ibid., Table 2 on p. 7[4] Ibid., Table 3 on p.8[5] Washington State Department of Health, Death with Dignity Act Reports, 2009-2015 available at: (link to the data). [6] Ibid.[7] Ibid.[8] David Albert Jones and David Paton, How does legalization of physician-assisted suicide affect rates of suicide?, SMJ: Southern Medical Journal, Vol. 108, Issue 10, p. 599-604, (link to the study).